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Medical Surgical Nursing Test - 6
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Medical Surgical Nursing
Test - 6
1. A nurse is caring for a client with type 1 diabetes mellitus. Because the client is at risk for hypoglycemia, the nurse teaches the client which of the following?
If the client is exercising, the evening dose of NPH insulin can be discontinued
Assess for signs of coma and drowsiness
Glucose tablets and subcutaneous glucagon should be made available
Urine should be monitored for presence of acetone
2. Ms. ALM has been diagnosed with Hashimoto's disease, an autoimmune disorder. Which of the following signs and symptoms were most probably exhibited by the client that led to the diagnosis?
Increased urination, weight loss, increased thirst
Increased appetite, weight loss, hyperdefecation
Decreased appetite, weight gain, constipation
Increased urination, weight gain, and purplish red striae
3. The Whipple procedure is the most common operation performed for pancreatic cancer and may be used to treat cancer and may be used to treat other cancers such as small bowel cancer. This procedure is done by:
Remove the majority of pancreas and stomach
Removing the head of the pancreas, most of the duodenum, portion of the bile duct and sometimes a portion of the stomach
Removing the duodenum, portion of liver and sometimes the portion of bile duct
Removing the head of pancreas, portion of liver and stomach
4. Dumping syndrome is a term that refers to a constellation of vasomotor symptoms after eating, especially following a Billroth II procedure. A patient who has undergone a Billroth II operation may prevent may prevent experiencing dumping syndrome by:
Bend over after meals
Lying down after meals
Stay in upright position after meals
Drinking water after meals
5. The appendix is a small pouch attached to the large intestine. Appendicitis is characterized by inflammation of the appendix. A patient with appendicitis is at risk for developing:
Hemorrhage
Pulmonary edema
Peritonitis
Bowel obstruction
6. The physician prescribes an order for the nurse to discontinue a patient's nasogastric tube. Before removing the tube, the nurse should:
Aspirate gastric contents to make sure that the residual volume is less than 50 ml
Assess for client’s bowel sounds
Make sure that the client is able to swallow and chew food
Determine the integrity of the taste buds
7. An ileostomy is a stoma that has been constructed by bringing the loop of the small intestine out on the surface of the skin. When assessing the client with a new ileostomy, the nurse knows that the effluent from the ileostomy should be:
Soft stool
Pasty to soft stool
Liquid to pastry stool
Well-formed stool
8. A client has a sliding esophageal hernia. The physician prescribes an H2-receptor antagonist. The nurse explains that H2 receptor antagonist works by:
Inhibiting secretion of gastric acid by the parietal cells
Neutralizing the gastric acid
Coating the mucus membrane of the esophagus and stomach
Decreasing the pressure in the lower esophageal sphincter (LES)
9. Dietary planning for a client with ileostomy would include telling the client to:
Limit the calorie intake
Restrict the amount of fluid intake
Encourage the patient to increase fluid intake
Avoid high-fiber foods
10. A colostomy was created in a client who was diagnosed with colon cancer. During the first day post-op, the nurse does not find any measurable fecal drainage from the patient's colostomy. What should the nurse do?
Irrigate the stoma
Call the doctor immediately
Continue the current plan of care
Encourage the patient to increase fluid intake
11. A client is admitted to the hospital after sustaining a fall from a roof. The client has plaster cast due to multiple lacerations and a right leg fracture. As the client's nurse, you will position the client's leg in which manner to promote optimal circulation?
Elevated on pillows continuously for 24 to 48 hours
Neutral position
Flat for 3 hours and elevated for 1 hour
Elevated for 3 hours, and then flat for 1 hour
12. The nurse should contact the physician immediately if Mrs. Warren has which of these findings?
There is 50 mL of serosanguinous drainage from the stoma.
The stoma appears red and shiny.
The stoma appears pale and dry.
There is 200 mL of dark green output from the stoma.
13. The nurse should contact the physician immediately if Mrs. Warren has which of these findings?
There is 50 mL of serosanguinous drainage from the stoma.
The stoma appears red and shiny.
The stoma appears pale and dry.
There is 200 mL of dark green output from the stoma.
14. When changing Mrs. Warren's ileostomy bag, the nurse notices that the peristomal skin is irritated. Which of these actions by the nurse would be appropriate before reapplying the appliance?
Clean the site with Dakin's solution.
Obtain an order for a topical antibiotic.
Wash the area with antiseptic soap and water.
Use a solid skin barrier.
15. Which of these comments, if made by Mrs. Warren before her surgery, would indicate that she had concerns about her body image?
"I'm so afraid I may not survive the surgery."
"I need to go shopping for some loose, baggy clothes."
"I will have to stop my aerobics classes."
"I'm concerned that this may be only the first of many surgeries."
16. Because Mr. Palmer is receiving heparin, it is essential for the nurse to
observe him for signs of pulmonary embolism.
limit his intake of foods high in vitamin K.
monitor his prothrombin time.
check the femoral puncture site at frequent intervals.
17. The valve prevents the backflow of blood into the right ventricle when the ventricular valve muscle relaxes
Tricuspid valve
Bicuspid valve
Pulmonary valve
Pulmonary artery
18. Which of the following is not the true regarding the GI Tract regulation?
The myenteric plexus regulates GI tract motility
The submucosal plexus regulates GI Tract secretion
The neurons of the enteric nervous system (ENS) can not function independently and are regulated by autonomic nervous system.
Parasympathetic fibres increase the activity of ENS neurons while sympathetic neurons inhibit them
19. Which condition is responsible for inspiration?
Dilatation of intercostals muscles
Contraction of intercostals muscles
Contraction of diaphragm
Both (Contraction of intercostals muscles) & (Contraction of diaphragm)
20. Glycosuria occurs when the venous blood glucose exceeds-
140-150mg/dl
150-160mg/dl
160-170mg/dl
170-180mg/dl
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